Indoor Air Quality in Healthcare Facilities

Nearly 60 percent of all healthcare buildings in the US were built during or after the 1970s, the decade during which energy conservation became a national concern and priority. The vast majority of these were for out patient care. In response to changes in building design, construction, operation and maintenance to save energy as well as the increasing use of synthetic building materials, the quality of indoor air has diminished.

Healthcare facilities, whether they are hospitals, clinics or doctor's offices, have to pay particular attention to indoor air, as people who visit them are frequently ill and often have compromised immune systems, making them more susceptible to adverse health reactions to poor indoor air quality.

Additionally, healthcare workers may spend many hours per day in less than optimal indoor environments with potentially greater likelihood of exposure to infectious agents. Also, some hospitals have special units that have special indoor air quality (IAQ) requirements, such as bone marrow units, neonatal intensive care units, isolation rooms and burn units.

Healthcare facilities comprise less than three percent of all buildings in the US, but have some of the most specialized indoor environmental requirements.

Designing and constructing a healthcare facility that provides acceptable indoor air quality, whether it is new construction or renovation of an existing structure, is a process during which each step is interdependent on those coming before and after. Failure in one step risks failure in subsequent steps and ultimately in the building itself. The lack of communication and coordination among the design professionals and construction team, and between the general contractor and subcontractors, often compounds the risk of failure, especially if the project gets behind schedule. Once occupied, proper operation and maintenance of a building is also of prime importance, as poorly operated and maintained buildings are prone to more IAQ problems. Another inherent risk is the lack of expertise and understanding of how the interrelationship of numerous factors can contribute to poor IAQ, both during design and construction and after occupancy.